Every patient — from coping to hoping. Every donor or volunteer — from altruism to inspiration. These stories inspire our work and compel mission advocates to give financially, join the registry, volunteer or spread the word.
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A marrow transplant may be someone’s only hope for a cure. Learn how marrow donation works, the steps of a patient transplant, steps of donation, and factors that can impact the likelihood of finding a match.
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Be The Match® is a global leader in bone marrow transplantation. We conduct research to improve transplant outcomes provide support and resources for patients, and partner with a global network.
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Bone marrow and
cord blood transplants can be used to successfully treat more than 70 diseases and conditions. Many times transplant is a patient’s only hope for a cure.

Commercial
insurance covers transplants for most, if not all, of these 70 diseases. However,
the Medicare program, which provides insurance to those 65 years and older and
those with a long-term/permanent disability, does not. This means that if
someone develops a disease or condition when 65 years old or older, he or she
may not have access to a life-saving transplant.

One of the greatest challenges we face
is making sure patients who are Medicare or Medicaid beneficiaries, as well as
those enrolled in Marketplace Exchange plans, have the same access to
transplant as those who rely on commercial insurance.

Medicare reimbursement

For transplants that Medicare covers, the amount reimbursed to the hospital or transplant center is less than the cost of providing the service. This is because current reimbursement rates do not cover the cost of finding a marrow donor or getting the cells needed for transplant.

Patient access to
life-saving bone marrow and cord blood transplants is a top priority for Be The
Match. We work closely with private insurers and government insurance programs
like Medicare and Medicaid to ensure access to treatment for all patients.
Inadequate Medicare transplants reimbursement, primarily for donor related
costs, poses a significant barrier to patient access.

Be The Match has
met with Medicare to present the challenges transplant centers face with
reimbursement and we proposed a solution to the problem. Our recommendation was
to reimburse transplants in the same way solid organ transplant are reimbursed.
Medicare pays for donor-related costs separately for solid organ transplants.
Medicare recently released the proposed inpatient payment rule for FY2019 and
we were hoping to see a change in the way donor related costs are paid for by
Medicare but unfortunately those changes were not included in the proposed rule. Please see the National Marrow Donor Program’s comment on the rule.

Two Paths, One Goal

NMDP’s Public & Payer Policy team
is committed to securing a solution to this patient access barrier. We have had
many discussions with CMS around a fixing this issue that would mirror the way
solid organ reimbursement is structured. At the same time, four Members
of Congress have introduced a bill, HR 4215 “Protect Access to Cellular Transplant(PACT) Act” that currently
has 22 co-sponsors and strong support from our grassroots advocates.

We need to continue our advocacy
efforts at CMS and with the U.S. Congress around HR 4215, because the lack of
attention to this issue will threaten Medicare patient access to
transplant. Medicare accepts public comments on all rules, anyone can
comment, and we hope you will take a moment to share your thoughts- we make it
easy!